I remember being asked this question many times by people I was meeting for the first time. I also remember asking other women the same insensitive question, simply because I too, like so many of us, had been conditioned to only value work that gets remuneration in return.

Looking back, the years during which I took a hiatus from work as a journalist, because I was looking after a home and my family, were the years I perhaps worked the hardest. Even physically.

Imagine for a moment that the women all around us – the mothers, the wives, the daughters and daughters-in-law, the sisters and the sisters-in-law – demanded they be paid for the care and services they provide to their families. Imagine what their bank statement would look like at the end of the year!

Let’s look at the numbers. Around the world, women spend two to 10 times more time on unpaid care work and domestic work than men – work that is not often counted in labour statistics. Countries have valued unpaid care work between 15% and 39% of national GDP. Data shows that women often have a higher total work burden than men when paid and unpaid work is combined.

On March 7, 2018, Data2X launched a new report –“Invisible No More? A Methodology and Policy Review of How Time Use Surveys Measure Unpaid Work” – with 18 case studies of countries that have started harnessing time use (TU) surveys to measure unpaid work and generate policy change regarding many issues relevant to social development. This is, in turn, making the world look at the tangible value of unpaid care and household work.

The report defines unpaid care and household work as work done by people to take care of their households and others – everyday unsung chores like cooking, cleaning, caring for children, the ill, and the elderly, and many other important tasks.

So many women among us are super women, literally. They do the jobs of cooks, cleaners, drivers, nurses, tuition teachers, psychological counsellors. They manage homes, finances and relationships. Any study of geriatrics shows that it is mostly, if not always, daughters who can be seen serving old parents and even parents-in-law.

TU surveys are important tools to understand where we, as members of the society, spend our most valuable asset – time. TU surveys, as the aforementioned report states, are quantitative summaries of how people spend their time over a specific period and how much time is spent doing each activity. These surveys help collect data that can be used to improve economic and social policies and have been used to advocate for policies that reduce the care burden, including expanding care for preschool children, elderly people, and people with disabilities. They inform and promote child protection policies by highlighting child labour and promoting broader child welfare systems. They help countries better value the contribution of unpaid care work to an economy, relative to GDP. Once we know who is spending time doing what in a society, countries can drive public campaigns to promote shared responsibilities in the home.

Today, we are celebrating International Women’s Day. And these issues can no longer be avoided. In rural areas, the load of carrying water still disproportionately falls on the women of the world because men, traditionally, do work that gets financial support for the family. But imagine if the women in rural Pakistan started charging for carrying the water back home. After all, this disparity does not only cost women time but also energy, and caloric requirements of water-fetchers increase – a requirement which is often not met for women. This is why now emphasis is being placed on highlighting the importance of men sharing the load of household chores with their women.

But what happens practically? The lion’s share of the food is given to the man because, hey, he is the one who earns. Managing a home, giving birth to children and then feeding them – it is a lot of unsung heroic work – one that needs to be appreciated. It’s high time.

As the Data2X report mentions, it is encouraging to see that slowly but surely, measuring reliably and comprehensively the unpaid household and care work traditionally performed by women has risen in prominence as a major challenge for official statistics.

Last year, in an encouraging initiative, the government of Sindh stood poised to adopt a policy for home-based workers (HBWs), making it the first province in the country to implement such a policy. Nonetheless, the fact remains that the list of home-based workers generally does not include the work women do at home.

Data2X’s new report mentions that in 2017, India’s Ministry of Labour and Employment’s Maternity Benefit (Amendment) Act recognising women’s time spent in care work, went into effect. Such policies are needed in all developing countries.

The time has come that not just men, but also women, start recognising the immense contribution of women in the survival of a family and a society. Every woman works, even though she may not get paid for it. So let’s not dismiss their contribution, for they are the axis around which a society revolves.

Farahnaz is a writer and editor, and has worked as the Features Editor with The Express Tribune. Her focus is human-centric feature stories. She now writes as a freelancer, and works in the fields of communications and media training. She loves literature and traveling. She tweets as @FarahnazZahidi. Her work can be seen at chaaidaani.wordpress.com/

Today a widow is not ready to accept her traditional role in society of being dependent on others for everything in life

Every family had a few such widows — some young and others older. Their presence was not considered auspicious, and they were supposed to lead listless sedentary lives devoid of any hope for a better future, waiting for stipends and hand-me-downs, with a looming sense of guilt as if that woman was somehow responsible for the death of her husband.

More than a decade and a half since we entered the third millennium, the widowed women of Pakistan find themselves a little ahead of where they once stood on the social ladder yet are still entangled in some deep-rooted traditions, stigmas and restrictions.

More than a decade and a half since we entered the third millennium, the widowed women of Pakistan find themselves a little ahead of where they once stood on the social ladder yet are still entangled in some deep-rooted traditions, stigmas and restrictions.

Farah Kamal, an education and development consultant, describes her journey decade by decade: she grew up in the 80s, got married in the 90s, and became a widow in the new millennium. “For those girls who grew up when I did, we were not raised to lead independent lives. When I became a widow, I suddenly found myself alone. And independent. Thus, for me, the societal attitudes posed the biggest challenge, more than the financial challenge as I was already a working woman and could support myself financially.”

With the loss of her husband, Farah was encouraged by people to start living with her parents and siblings or to get a relative to live with them, a suggestion she did not accept. “We have the stereotypical image of a widow. She should be depressed, subdued, dressed in sober clothes. But today’s widow is not going to sit in a corner dressed in white, dependent on others to give her charity.”

It is not just the woman who has lost her husband that suffers the impact of social stigma that surrounds a widow. It is also her children. While Ahmer Ali was an adult when he lost his father five years ago, his experience and observing as a son what his mother has gone through has taught him a lot about the plight of a widow. “For my mother and my siblings, both finances as well as the emotional trauma were huge challenges, as were the social taboos. Take a small example that in our society a widow is supposed to dress as soberly as she can. My mother loves to wear bright colors but after my father passed away I observed she begun to avoid clothes of colour. However, I ensured that she wore what she liked,” he says.

Commenting on social attitudes, Ahmer confesses that if the prospect of his mother remarrying would have come up soon after his father passed away, he may or may not have been able to accept it. “Five years down the lane, I say to myself ‘why not?’. People need to understand that widows also have a right to lead their lives as they wish, and have a right to start afresh if they like. In Islam, there is no obstacle in a widow’s remarriage; it is in fact encouraged. The clergy needs to spread awareness about this. But instead of encouraging the widow to move on with her life, people make the one who is mourning cry more. Social attitudes towards widows need to change. It is time.”

For Nazia* (name changed on request), the experience was not entirely negative when it came to how people acted towards her after she lost her husband. “My friends and family were quite empathetic and helpful when it happened,” she says, but adds that the experience has been mixed, “Because on my husband’s first death anniversary, my relatives, and that too close ones, called and expected me to be crying and be really sad. Incidentally, my daughter got engaged two years later on the same date that my husband had died, and even my closest of kin said, ‘why did you do it on the same date?’ I got tired explaining that the boy’s sister was leaving the next day so I did not have an option,” she says. “To date, I feel people observe me intently, and expect me to be sad and depressed,” she adds.

Yet, life has not allowed her that liberty. Gaping challenges faced this mother of two when her husband passed away, leaving them in the midst of financial challenges. “I didn’t really get any time to mourn. I was out of the house on the fourth day for the death certificate. Who else was there to support me and my girls?” As her family did not own a house, Nazia had to arrange a place to live soon after becoming a widow, and started working full-time to support herself and her daughters. “I heard comments like ‘haan haan tum to buhut independent ho, tumhain kisi ki zaroorat nahin (You are a very independent woman, seems you need no one)’.” But she did what she had to in order to survive. “In so many ways, I have become a stronger woman since I lost my husband,” she says.

Another social attitude is the assumption that widowed women are on the lookout for a man to remarry. “My male colleagues stopped visiting me [even for work] because their wives did not want their husbands to interact with me,” says Farah. She poignantly describes the experience of being widowed: “It was like being off-loaded on a dark highway in the middle of a journey.” Her being a financially empowered single woman has proven to be another challenge, as men see such a woman as a lucrative prospect.

Advising young girls, Farah says girls need to be independent and educated to be able to support themselves if such a situation in life arises. She is also of the opinion that girls should weigh carefully factors like health and lifestyle of a man before marrying, because unhealthy lifestyles or diseases of a man may result in his prematurely leaving this world, and the widow being left to suffer.

“I hate when in the ‘marital status’ column, I am asked to write ‘widow’,” Farah says. “This status does not identify who I am. I have also realised that my happiness is my own responsibility, as is my survival. This trial has made me stronger as a woman.”

Internet connectivity is helping a lot of beauticians who have opted for working from home

When Rizwana Raza started taking appointments at home as a home-based make-up artist and hair stylist more than a decade ago, her reason was not being able to leave young children alone at home, and to be able to manage her home while working. “It was a more convenient arrangement than working at salons that used to take up the entire day. This allowed me to juggle many things simultaneously, particularly being able to run my home and be there for my children,” she says.

All these years later, working from home still remains her choice even though she has been offered more lucrative full-time work options at well-known salons.

Home-based beauticians and make-up artists are all the rage in Karachi, and the reasons are many. A huge advantage which many make-up artists, like Qirat Baber, are using is the social media to advertise their work. “I was the first home-based make-up artist in the city on Snapchat. I use SnapChat, Instagram and Facebook to advertise my work. It is not without challenges as I only work by appointments so potential customers cannot just walk in to see my work and have to rely on photographs,” says Baber.

Home-based beauticians and make-up artists are all the rage in Karachi, and the reasons are many. A huge advantage which many make-up artists, like Qirat Baber, are using is the social media to advertise their work.

Yet she is very happy with working from home as it allows her to work in her own space, and at her own pace. Baber also appreciates the fact that she gets more undivided time with each client, and clients also have come to appreciate this rather than being in a salon that has many clients sitting in queues waiting to be dolled up. “Salons can become fish markets,” she says, sharing that she works with a single helper.

Another popular young home-based stylist, Rija Bakhtiar, started practising the art three-years ago, and now she has taken her passion to the next by setting up a salon at home. “Home was the only place at that time for me to start my business on a small scale. The working hours are flexible and the overheads are less as compared to opening up a studio. It has turned out to be my best decision,” she says. Internet was and is her only source of advertisement. She relies on Snapchat, Instagram, Facebook and Whatsapp.

All three make-up artists agree that money is also saved by the fact that they don’t have to pay taxes. “However, it is not like we have no overheads. The investment in equipment is a lot. Also, I mostly get my supplies online which proves to be quite expensive,” says Baber.

For Bakhtiar, one challenge is that she can’t cater to large numbers of clients. “I have to stick with limited clients to maintain a normal environment at my home,” she says.

One difficulty these artists face is that if they do not provide other services like waxing, threading and face polish, for example, their clientele becomes limited. “And many clients do not like the home atmosphere. They like the ambience and hustle and bustle of a salon,” says Raza.

When asked how she makes up for that disadvantage, she candidly answers that she does so by keeping her rates very reasonable, by serving them coffee and snacks and working on developing a rapport with them. “I make friends out of my clients. Once that happens, they continue coming to me.”

For women leading hurried and over-worked urban lives, malls are perhaps more of sanctuaries than merely a collection of shops

The roads leading to malls are choked with activity and traffic. Dolmen, Packages, Centaurus — these are household names and second home to Pakistani urban families.

When experts look at the demographics of those who frequent malls in Pakistani cities, the number of women is much larger than men, an easy double figure apparent even to the common observer. Mall culture has definitely arrived with a bang in Pakistan, and women are the reason why malls are the hub of hustle and bustle.

For people like Mehek Masood, it is simply more convenient to go to a mall as one can find all the brands under one roof. “Malls give us a totally different shopping experience. Not only are they facilitating us in the form of parking but food courts are also a big reason.”

For people like Mehek Masood, it is simply more convenient to go to a mall as one can find all the brands under one roof. “Not only are malls facilitating us in the form of parking but food courts are also a big reason.”

For young working women like her, shopping at a mall is preferable “because I can just hop from one shop to another. Whereas if I visit Zamzama or any other place, not only is it difficult to find parking in all that clutter, but I also feel that I am somehow rushing my buying decision,” says Masood who calls shopping at a mall a “recreational activity”.

Most women would agree that a mall is more than just shopping — it serves as a public space for families and friends in a country where safe and comfortable places are simply not enough. Malls also happen to be air-conditioned, and women, along with children, throng to malls for the comfort of lowered temperatures when mercury rises.

For Rushna Shamsi, a mother of four, it is the place of preference when she thinks of an outing with her children. It’s safer, more convenient, and provides one stop shopping. As a mother of young children it is an ideal choice. “My teenage boy enjoys the food court. My pre-teen girl loves shops with accessories. The toddler fits herself at the play area for kids. I love the food, the shopping, the ambience — all of it. But with kids it does get heavy on the pocket if visits are frequent,” she says, adding that for her the fact that malls provide a hygienic public space is also a factor that ropes her in.

However, looking at it from the perspective of the entrepreneurs and retailers that have shops in malls, women coming to malls might form the largest body of visitors, but are not the most serious buyers.

Ayesha Mansoor, the driving force behind popular brands for women’s clothing — Mausummery and Origins — says that women go to malls for the overall entertainment experience. “They are not serious shoppers. The visitors to shops in malls that come in are usually there for an outing or an eating spree. Malls are becoming popular as entertainment spots. Eating, grocery or even just window shopping are the main attractions,” she says, adding that retail sales are not doing well in malls due to high overheads. When asked why all brands still have shops in malls, her answer is simple: “to have brand presence”.

Not all women are fans of the trending mall culture. One such woman is Beena Imran. “In my opinion, with the busy lives that we lead nowadays, going to a mall is nothing but a waste of time unless you have nothing better to do. If I know what I want, and have jotted it down, I’d rather go to an individual shop than going through the hassle of reaching a mall, spending a good 15-20 minutes in reaching my desired shop and mostly not getting what I went for in the first place,” she says.

Yet, even women like her who are not big on malls acknowledge the reasons why malls are becoming popular. “They provide a recreational place for people from all walks of life. Some of them just go to the mall to sit and kill time. It may be a source of happiness for them and could help them forget their worries or problems in a lively atmosphere.”

For women leading hurried and over-worked urban lives, then, malls are perhaps more of sanctuaries than merely a collection of shops.

Plays like these are integral in raising awareness and educating society about the care of the elderly and creating a more inclusive society. PHOTO: COURTESY AKU

KARACHI: Dialogues interspersed with laughter from the audience at Aga Khan University’s packed auditorium on Monday while watching a play on dementia. Watching attentively, there were many moments of silence where audience found itself relating to the pain of having seen a loved one go through the ordeal of dementia.

The play, ‘Main Bhool Gaya’, was created by Patronus Theatrics, which is a production group run by students and faculty of AKU. It was aimed at raising awareness about dementia and the story showcased a family’s struggle in caring for an elderly father suffering from the disease.

Dementia is a disease that mostly affects the elderly, but can also be triggered due to other factors or ailments. It can often go unnoticed by family members and health professionals in Pakistan. Often, the signs of dementia are misconstrued as being ‘a normal part of ageing’.

Patients of dementia forget not just words, but a sense of time and whether they are in the past or in the present. As it is a progressive disease, the patient starts forgetting basic physical functions overtime.

While it is painful for the patient, it is equally difficult for the family and caretakers who often do not understand how to handle the situation. The play portrayed how a family struggled to tackle the issue, particularly the daughter who was most sincere in her service to her aging father.

AKU Department of Family Medicine Associate Professor Dr Saniya R Sabzwari was the executive producer and wrote the script, along with Kumael Azhar and Ibrahim Sajid. At the end of the play, she expressed the importance of spreading awareness about dementia.

“Humourous moments have been added to the play to give the audience a breather,” said Dr Sabzwari, explaining that the topic of dementia can be depressing.

The play was directed by Sunil Shanker with Maeen Abbas as the student director and Kaleem Ahmed as the student producer. The actors received a thunderous applause at the end, particularly Azhar, who acted as Colonel Haidar, a man who began to forget who he is, yet was kept company by a younger version of himself in his world of alternative realities.

Dementia, as the play highlighted, is not just about ageing, but is a disease that needs to be understood, as does the plight of both the patients and the caretakers. Plays like this are integral in raising awareness and educating society about the care of the elderly and creating a more inclusive society.

He is a normal-looking person, leading a seemingly normal life. His eyes are not crazed. He is not unkempt. He has a job and has normal social interactions. There is no apparent sign of a mental disorder. Yet a dark secret lurks behind the shadows — he is a child sexual abuser. There is no formulaic profile that fits a perpetrator of child sexual abuse. There is no way even an adult can identify him or her, leave alone a child. Seven-year-old Zainab of Kasur fell prey to one such felon whose crime remained invisible till Zainab was found, albeit too late.

As Pakistan grapples in the wake of this shocking incident, it is time to raise awareness not just about the crime but also about the criminal who is often imperceptible.

“There is no single profile for a perpetrator of child sexual abuse because not every child sexual abuser is a pedophile. Pedophilia is a disorder and a specific sexual preference; it is a sickness,” says Dr Asha Bedar, clinical psychologist, trainer and researcher, who has worked extensively with cases of child sexual abuse.

As Pakistan grapples in the wake of this shocking incident, it is time to raise awareness not just about the crime but also about the criminal who is often imperceptible.

In her professional experience, Bedar has seen that many perpetrators are not pedophiles. “They can be very seemingly normal and functional people who have no diagnosed mental illness. They can be respected members of the society. They can be popular in social circles, hard to detect and harder to believe to be sexual predators of children. This makes it doubly tough for children to identify them as well.”

About pedophiles, Dr Uroosa Talib, Psychiatrist and Head of Medical Services, Karwan-e-Hayat Hospital, says that they are not recognisable by appearance, speech or demeanour. “To get to the child, they develop a step by step plan. They first observe how they can build a rapport with the child. These are sharp, brutal, cruel people who will go to any length to get what they want.”

Among the celebrities who have courageously spoken up about being survivors of child sexual abuse is female actor, Nadia Jamil, who has used the platform of social media to draw attention to the issue, and toward other victims like Kainat Batool.

Jamil echoes the view of experts that there is no set profile of such a perpetrator of child sexual abuse, or a rapist. “Any man could potentially sexually abuse or molest a child. Rich men have raped and will. Poor men have raped and will. Literate and illiterate men have raped and will. Until you deal with violent and domineering stereotypes created by patriarchy, men will continue to abuse,” she says, sharing her views with TNS.

“Pedophilia is a disease. True pedophiles are attracted sexually to pre-pubescent children in general. The urges and reasons behind the act of abuse may be different between a pedophile and non-pedophile abuser but the danger is the same — being aroused by a child,” she says, adding that not all abusers are men.

Dr Talib says the commonest emotional trauma that leads to personality disorders is child sexual abuse, even if the impact remains only as a suppressed memory or is clouded by denial. “This is one of the most difficult traumas to ever get over. The victims, in turn, can become perpetrators, and often use sex for power. Their morality changes.”

Earlier this week, the Women’s Action Forum (WAF) sent recommendations to the State, as well as to the National Commission on the Status of Women (NCSW); one of these is to conduct psychological and psychiatric evaluations of those convicted of sexual abuse and rape, including of minors.

Bedar also says that research shows that the numbers of girls and boys sexually abused is almost the same. “But due to years of social conditioning boys internalise the idea that they can protect themselves; they do not want to accept their vulnerability. Gender dynamics and abuse have a very strong connection,” she says, adding that socially generated ideas of masculinity make the boys think that ‘if I can’t be a victim than I must have been a part of it’.

Thus, many male victims grow up telling themselves that they must have consented to it, especially if the abuser was a woman. “Boys are also more vulnerable in some ways as they are outdoors more often and parents allow sons to be with strangers like drivers or helpers more readily compared to daughters.”

Evidence suggests that child sexual abuse and rape is linked to gender-based violence in general. “Strong gender role socialisation, power dynamics, myths about gender and rape, lack of strong sanctions and strong male peer support for masculinity and role modelling” are some of the dynamics Bedar feels need to be looked into.

Experts agree that the core to the solution is making the children more aware but parents are a big part of this equation. “Parents need to have a relationship and connectedness with their children that their child can come and share not just successes but also failures, so that if anything like this happens that makes the child feel embarrassed, he or she can still share it with their parents and their parents believe them,” says Dr Talib. “Giving a child the concept of religious boundaries can actually work positively. This also helps them understand the concept of good and bad touch with keeping religious sensitivities in mind. Teach your children rights over their self and the dignity of their bodies.”

Jamil says she would be wary of strange men paying too much attention to a child. “We have to teach our children to be vigilant and to protect themselves and others. Warn them. Keep an eye on them and pray hard. And we have to change the way we educate ourselves and our kids. Till the state invests in the right people…it’s up to us. One child at a time. We cannot afford to stop or give up. We will not give up.”

Rising population poses a serious threat to Pakistan’s progress. Here are a few suggestions by experts to stem the crisis

The biggest issues facing Pakistan are the booming population growth and the lack of awareness across the board regarding how big a threat this poses to the country’s progress. Simply put, the country has too many people and not matching resources in the spheres of food, health, education, and employment systems. Conferences are held and experts join their heads in exasperation to think of policies and projects that can manage this unbridled growth. Yet, the most basic of problems is often overlooked — raising awareness.

If enough efforts are not made to slow down Pakistan’s population growth rate, the population will likely increase from the current 189 million people to 310 million by 2050 (UN DESA, 2015). But this is a conservative estimate. According to President Population Association of Pakistan and Chairman Punjab Higher Education Commission Dr Nizamuddin, the country’s population would cross the 395 million mark by 2047. He said this at the recently held Eighteenth Annual Population Research Conference, Population Growth and Investing in Human Resource Development, in collaboration with Government College University Lahore. With just three years left to achieve its FP 2020 targets, Pakistan’s high growth rate of 2.4 per cent depicted in Population Census of 2017 asks for serious efforts.

Speakers at the conference gave different and relevant solutions to how the challenge can be met. Dr Aziz Rab of Greenstar Marketing emphasised on a number of ideas, all aimed at raising general awareness among people regarding family planning, like a toll free number where people can get guidance regarding FP, as well as free air time for the purpose. However, all of this would need political will and support from the government.

If enough efforts are not made to slow down Pakistan’s population growth rate, the population will likely increase from the current 189 million people to 310 million by 2050 (UN DESA, 2015). But this is a conservative estimate.

Dr Attiya Inayatullah, Chairperson Rahnuma Group of Pakistan, pressed upon the need for public-private partnerships to achieve the desired targets. She expressed the need to bring the private sector on board in all FP efforts, as well as leveraging men to become allies in this endeavour. Stalwarts of the field like Dr Mehtab S. Karim, Executive Director, Centre for Studies in Population & Health, Dr. Zeba A. Sathar, Country Director, Population Council, and Dr. Farid Midhet, Vice President, Population Association of Pakistan & Country Director, Jhpiego Pakistan, participated in the conference.

A panel discussion on Pakistan’s 6th population census results, organised by Jhpiego and the Population Association of Pakistan, had experts debating the methodology of the population census 2017. Journalist Zofeen Ebrahim who was invited as a panelist at the session, said that now that Pakistan has a fair idea of the numbers “we need to focus on planning for the people in earnest instead of quibbling over the methodology of the census”.

As Dr Inayatullah pointed out, Pakistan has the know-how and can achieve the targets. What it needs right now is a reality check, she said. “There are two gaps: Implementation is key for which we must get down to the grass roots. And secondly, where do we find a political leader who will speak out boldly in an upfront manner about this?”

A possible solution

While moots like the aforementioned conference give the much needed impetus to the issue at the top of the pyramid, doctors working at grassroots level like obstetrician Dr Halima Yasmeen at the Jinnah Postgraduate Medical Centre (JPMC) Karachi, feel that growth rate cannot be slowed down till awareness is raised. For this, dedicated counselors who can talk to women and convince them to use contraceptives can play a core role.

“It is an evidence-based fact that introducing a cadre of FP counselors shows better results when it comes to use of contraceptives. These counselors should be there at hospitals 24/7, just like nursing and janitorial staff is there round the clock. And their job should be only to talk to people,” she said, emphasising the importance of convincing people to use contraceptives.

“Our doctors are fulfilling their own dreams, and are on autopilot mode. What they are not doing is fulfilling the needs of this country as a whole,” said Dr Azra Ahsan, gynaecologist and consultant at the National Committee for Maternal and Neonatal Health (NCMNH). Dr Ahsan, while talking to The News on Sunday, expressed that the key to solving this problem lies in sensitising healthcare practitioners. “Every healthcare provider should know about providing family planning (FP) services. But they are not taught how to do it properly even in medical colleges. They don’t even know how to manage post-partum hemorrhage, because there is no glamour in this kind of healthcare service,” she says.

With mobility restrictions and traditional barriers, women don’t readily come to hospitals and clinics. However, the rates of women opting for deliveries in hospitals or healthcare units has gone up considerably, and this allows a great opportunity to convince them for post-partum contraception. “Most women do not come back for follow ups, which means that they will not get contraception-related advice in time,” says Dr Ahsan, commenting on golden opportunities that keep slipping through the net.

A project of NCMNH involved stationing two to three dedicated FP counselors in selected hospitals in Karachi, and this strategic placement multiplied the number of women opting for contraceptives like Intra-Uterine Devices (IUDs). “The day the counselors didn’t come, we saw that no women opted for contraceptives,” says Dr Ahsan.